Executive Editor: Joseph Schatzker, Peter Trafton

Authors: Ernst Raaymakers, Inger Schipper, Rogier Simmermacher, Chris van der Werken

Proximal femur - Trochanteric fracture, pertrochanteric, multifragmentary - Nailing

back to skeleton


Postoperative treatment

Intramedullary fixation of these fractures allows for immediate postoperative full weight bearing rehabilitation.


Follow up visits at six-week intervals with x-rays should be carried out until union and thereafter as necessary.

Implant removal

Implant removal is not necessary unless clinically indicated.

Prognosis of proximal femoral fractures

After surgery the outcomes of greatest concern are
  • mortality
  • loss of independence
  • loss of mobility
  • residual pain.

Mortality generally occurs within the first six months after fracture; studies have shown that these rates range from 12-37%.
Predictors of higher mortality rates are patients who are:

  • older
  • male
  • have other comorbid conditions (such as cardiac failure, diabetes, and chronic air flow limitation)
  • have cognitive disorders.

For more information see the additional material on perioperative care in elderly hip fracture patients.

v2.0 2010-11-14